BUFFALO, N.Y. -- After sustaining a concussion, when can an
athlete safely return to play? That's the primary question for
professional and amateur athletes alike.

Now, University at Buffalo sports medicine researchers have been
awarded $100,000 from NFL Charities to develop the most objective,
scientific method of determining when an athlete who has had a
concussion can safely return to play.

NFL Charities, the charitable foundation of the National
Football League owners, has awarded the 18-month grant to
researchers at the Concussion Management Clinic in the Department
of Orthopaedics in the UB School of Medicine and Biomedical
Sciences. The grant to UB is one of 15 totaling $1.5 million that
NFL Charities is providing to researchers nationwide to support
sports-related medical research on concussion/traumatic brain
injury and cardiovascular medicine.

"Concussion itself poses little risk if it is properly managed;
the only risk acutely is hemorrhage, which is generally detected
through CT scans," says John Leddy, MD, director of UB's Concussion
Management Clinic; clinical associate professor of orthopaedics,
family medicine and rehabilitation sciences; and principal
investigator on the grant.

"However, return to play before complete recovery involves much
more serious risk," Leddy continues. "Therefore, it is important
that a systematic, scientifically based return-to-play protocol be
established and that it is proven to be valid and reliable. This is
what we will be doing with this grant."

To date, that hasn't existed, he says, with team physicians
often relying on more subjective assessments of an athlete's
ability to exercise without experiencing symptoms.

Leddy will conduct the research with his colleague, Barry
Willer, PhD, UB professor of psychiatry and rehabilitation science,
who is co-principal investigator on the grant.

Over the next 18 months, the UB researchers will test between 35
and 50 athletes from the Buffalo Bills, the Buffalo Sabres and
athletes from Western New York colleges, including UB, who sustain
concussions in the 2012-2013 season, as well as healthy control
subjects.

"We are excited that NFL Charities has awarded this grant to
University at Buffalo sports medicine researchers," says Mary Owen,
Bills executive vice president for strategic planning. "The
research that will be conducted by Dr. Leddy, Dr. Willer and others
will benefit athletes at all levels and this is another example of
how the Bills and the NFL continue to give back to our Western New
York community."

Physiological variables that will be tested during exercise in
concussed athletes and healthy controls include heart rate, blood
pressure, pulmonary ventilation, cerebral blood flow and other
measurements that Leddy and Willer have demonstrated are impacted
when someone has had a concussion.

"We'll take these measurements both when concussed athletes are
still having cognitive symptoms and when they feel like they have
recovered," says Leddy. "We'll be looking at sophisticated MRI
images and measuring the athletes' ability to exercise to a maximum
rate without a return of their symptoms, all of which will help us
gather more objective physiological evidence."

Leddy and Willer have completed smaller, pilot studies showing
that a controlled, progressive exercise program using a standard
treadmill test can successfully treat athletes who have undergone
concussions.

In addition, they note, the physiological responses to the
treadmill test are objective. "Thus, athletes cannot 'fake' their
way through, or minimize symptom reporting, while undergoing the
test," adds Willer.

In addition to Leddy and Willer, other investigators on the
grant include John Marzo, MD, team physician for the Buffalo Bills,
and Leslie Bisson, MD, team physician for the Buffalo Sabres, both
of whom are UB clinical associate professors of orthopaedics.

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